A manual of diseases of the throat and nose : including the pharynx, larynx, trachea, œsophagus, nose and naso-pharynx / by Morell Mackenzie.

  • Mackenzie, Morell, 1837-1892.
Date:
1884
Catalogue details

Licence: Public Domain Mark

Credit: A manual of diseases of the throat and nose : including the pharynx, larynx, trachea, œsophagus, nose and naso-pharynx / by Morell Mackenzie. Source: Wellcome Collection.

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    sometimes be olitaiiied as to the condition of the neigldionv- ing parts. Thus deep-seated abscess of the neck, enlarge- ment of the glands, fibroid thickening of the thyroid body, or the pulsation of an aneurism may be detected, whilst the negative evidence aifordeil by the absence of swelling or tenderness in the cervical region may in certain cases l)c important. Aim’ultation of the €Exox>lia(Jus.—This consists in listen- ing either through the stethoscoiie or directly with the ear over the course of the gullet, whilst the patient swallows some fluid. The proposal of this method of examination is entirely due to Hamburger, and the short articles since pub- lished 1)y myself,! Elsberg,'^ and Cliftbrd Allbutt'! are little more than epitomes of Hamburger’s'! essay. (Esophageal auscultation is easily carried out, but it recpiires considerable practice and much patience ; practice, because it is recpiisite to get the ear well accustomed to the normal oesophageal sounds; patience, because in each case it is necessary to apply the stethoscope successively down the whole length of the oesophagus, and to listen attentively at each spot. Before attempting to ajiply the method in disease it i.s essential to become ac(piainted with the normal sounds jwoduced in deglutition; and for this purpose repeated examinations should be made on healthy persons. Tlie following is the liest way of practising the art. The individual to be examined .should be directed to take a mouthful of drink—water does very well for the purpose, Vmt a thickened fluid, such as gruel or arrowroot, answers better. The stetlioscoj)c is then applied over some portion of the food-tract, the j)er.son is directed to swallow, and the sound produced in the act of deglutition carefully listened to. As the small portion of fluid, or, as it has l)een somewhat arbitrarily called, “the morsel,” passes down the throat it proiluces various sounds, and conveys certain impressions to the mind of the li.stener. The ])roi)er interpretation of the.se sounds constitutes the art of a*so])hageal auscultation. If the .stethoscope be ajudicd to the side <jf the neck, on a level with the hyoid bone, and the person be directed in .SM'allow a morsel, a loud, gurgling noi.se is heard, which ! “Lancet,” May 30, 1874. “ Au.scultatioii of the (Esoj)hagii.s.” l’liila(l(4phia, 1870. “British .Med. .loiini.” 187.0, vol. ii. p. 420. ■* “ Klinik der (E.so[diagiiskranklicitcii,” Erlangen, 1871. Hani- hurger’s view.s, liowever, liad hcen develoj)ed previou.sly in a serie.s of papers ill tiie “ tEsterreieh. Med. .lalirh.,” 1867, 1868, i860.